Menopause Symptoms and Memory Loss

While you may experience the misery of hot flashes and mood swings as you enter menopause, one thing you can't blame on the "change" is memory loss.

In the latest study that exonerates menopause as a cause of impairing the ability to recall, Taiwanese researchers compared the memory of hundreds of women before they had any menopausal symptoms to their memory as they entered menopause.

They found the women who were going through the menopausal process scored as well or nearly as well on five different cognitive function tests. Results of the study are to be presented Oct. 4 at the American Neurological Association annual meeting in Toronto.

"When women go into perimenopause, they don't need to worry about cognitive decline," said Dr. Jong-Ling Fuh, an attending physician at Taipei Veterans General Hospital and an associate professor of Yang-Ming University School of Medicine.

The researchers said the myth of memory loss during menopause is a perception some women have because as they went through menopause, they felt their memory wasn't as sharp as it had been before. Studies suggesting that hormone replacement therapy might protect against dementia strengthened that belief. However, a large study later found that in older women, hormone replacement therapy not only didn't help protect women from dementia, but could actually increase the risk.

To try to answer the question of whether menopause did have any effect on memory, Fuh and her colleagues studied nearly 700 premenopausal women living on a group of rural islands between Taiwan and China. The Taiwanese government restricted access to these islands until the 1990s, so the authors report that the study's population was nearly homogeneous, which would help rule out other potentially causative factors of memory loss.

The women were between the ages of 40 and 54. None of them had had a hysterectomy, and none took hormone replacement therapy during the study.

All took five cognitive tests designed to assess their memory and cognitive skills at the start of the study, and then again 18 months later.

During the study period, 23 percent of the women began to have symptoms of menopause.

The researchers then compared the memory of the women who had entered menopause to those who had not, and found very little difference. In four of the five tests, there were no statistically significant differences in the two groups of women.

Only on one test was the difference statistically significant, and that difference, said Fuh, was very slight. This test was designed to assess verbal memory and involved showing the women 70 nonsensical figures. Some of the figures were repeated during the test, while most were not. The women were asked whether they had seen the figure earlier.

"For women, menopause does not mean you'll develop memory loss," said Dr. Raina Ernstoff, an attending neurologist at William Beaumont Hospital in Royal Oak, Mich. As you're going through perimenopause and experiencing symptoms like hot flashes, she said, you may feel lousy and have trouble sleeping, which might temporarily affect your cognitive skills.

"I don't think declining estrogen levels are what causes memory loss," said Dr. Steven Goldstein, an obstetrician/gynecologist at New York University Medical Center in New York City. "It's not like your memory is bopping along, doing fine and then takes this big dive during menopause, like bone density can."

Both Ernstoff and Goldstein said they weren't aware of many women who believed that menopause might cause significant memory loss. They also both felt that results from this group of women who were so homogeneous might not apply to different groups of women, such as those living in more industrialized society. And they both said that other factors that weren't studied could play a role in memory loss, such as hypertension, which can contribute to vascular dementia.

Ernstoff also pointed out that the education backgrounds can play a large role in memory loss. Fuh acknowledged the researchers did attempt to control the data for educational differences.

SOURCES: Jong-Ling Fuh, M.D., attending physician, Taipei Veterans General Hospital, and associate professor, Yang-Ming University School of Medicine, Taipei, Taiwan; Steven Goldstein, M.D., obstetrician/gynecologist, New York University Medical Center, and professor, obstetrics/gynecology, New York University School of Medicine, New York City; Raina Ernstoff, M.D., attending neurologist, William Beaumont Hospital, Royal Oak, Mich., and member, Alzheimer's Board of Detroit; Oct. 4, 2004, presentation, American Neurological Association, Toronto.

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New treatment for Hot Flashes

An anesthetic injection into a collection of nerves in the neck of breast cancer survivors may reduce the severity and frequency of debilitating hot flashes and night awakenings associated with breast cancer treatment, according to a new study published online today by The Lancet Oncology and appearing in its June issue.

Check out this new information at the Everything Menopause June 2008 Newsletter

Things to Know About Birth Control

Birth Control

-- abstinence - still the only 100% effective and proven birth control

-- Barrier methods prevent the sperm from reaching the egg for fertilization
- condom
- diaphragm
- cervical cap

-- Intrauterine device (IUD) a small device that is inserted into the uterus by a health care provider that prevents a fertilized egg from implanting in the uterus

-- Hormonal methods release hormones into a woman’s body that interfere with fertility by preventing ovulation, fertilization, or implantation.
- birth control pills
- birth control patch
- birth control injections (like Depo-Provera)
- vaginal rings (like the advertised NuvaRing)

-- sterilization by surgical procedure is often a choice some women make, also known as a tubiligation or "having your tubes done"

-- male sterilization by surgical procedure, a vasectomy

-- planning by following your ovlation cycle on the calendar and remaining abstitnent during ovulation times. This requires careful record keeping and knowing when ovulation begins and ends.

-- Essure is a different type of tubilagation in women where a coil is placed into the fallopian tubes.

Hysterectomy Facts

-- Approximately 300 out of every 100,000 women will undergo a hysterectomy.

-- hysterectomy is surgery to take out a woman’s uterus

-- Other organs (cervix, ovaries, and fallopian tubes) might also be removed if you have severe problems such as endometriosis or cancer.

-- Whether or not the ovaries are removed depends on age and risk for certain types of cancer

-- hysterectomy is usually done to treat problems with the uterus, such as severe pain and heavy bleeding caused by endometriosis or fibroid tumors

-- most women are in the hospital 1 or 2 days after the surgery, sometimes up to four days depending on circumstanes and health

--Only 10% of hysterectomy are performed because of cancer.

Non-cancerous reasons for hysterectomy are common

-- fibroids - are common non-cancerous (benign) tumors of the uterus and they are the most frequent reason for recommending a hysterectomy

-- endometriosis - a noncancerous condition in which cells from the uterine lining grow like islands outside of the uterus

-- prolapse - the bladder and/or rectum may be pulled downward with the uterus. This happens to most women to some degree. For the vast majority, the sagging is minor and symptoms are not severe. A hysterectomy with repair of supporting structures is usually recommended in more serious cases.

-- pelvic adhesion - irritation of the lining of the abdomen may cause adhesions (scarring) which bind affected organs to each other. The adhesions can result from endometriosis, infection or injury.

* Abdominal hysterectomy. In this type, the doctor makes a cut in the belly, either across the bikini line or straight up and down. The doctor takes out the uterus and the cervix. This type is most often done when cancer might be present or when severe endometriosis, a lot of scar tissue (adhesions), or a very large uterus makes the uterus hard to remove.

* Vaginal hysterectomy. With this type, the doctor takes out the uterus through the vagina. He or she makes a small cut in the vagina instead of the belly. Your doctor will not use this method when there is a chance that cancer may be in the uterus, cervix, or ovaries. Doctors use this type of surgery only in cases where the uterus is small and easy to remove.

* Laparoscopically assisted vaginal hysterectomy (LAVH). To do this surgery, the doctor puts a lighted tube (laparoscope) through small cuts in your belly. The doctor can see your organs with the scope and can insert surgical tools to cut the tissue that holds your uterus in place. Then he or she can remove the uterus through your vagina.

* Laparoscopic supracervical hysterectomy (LSH). With LSH, the doctor inserts the scope and tools through small cuts in your belly. He or she takes out the uterus in small pieces and leaves the cervix in place. This surgery is done only if you don't have cervical cancer.

* Total laparoscopic hysterectomy (TLH). In this type, the doctor inserts a scope and tools through several small cuts in the belly. The doctor takes out the uterus and the cervix in small pieces through one of the cuts.

A Blood Test to Predict Menopause

Any woman approaching her 40s knows that time is not on her side when it comes to fertility. A decade before menopause, her chances for having a child begin to dip. But what if women could pinpoint when they will hit menopause, and figure out exactly how many child-bearing years they have left?

That's what scientists in the Netherlands have done. Reporting in the Journal of Clinical Endocrinology and Metabolism, they report that a simple blood test, for a hormone called anti-Mullerian hormone (AMH), could help women predict when they will enter menopause, and therefore how to set their fertility timetable.

Read more here

Acupuncture Reduces Tamoxifen-Induced Hot Flashes by Half

Knowing that acupuncture provides effective relief from hot flashes and other symptoms associated with menopause, Jill Hervik, a physiotherapist and acupuncturist, conducted a trial to see if the same relief could be achieved in breast cancer patients taking tamoxifen after surgery for estrogen-sensitive breast cancers. Tamoxifen causes some of the same symptoms that are associated with menopause.

read more here

Pellet Hormonee Implants

A woman in the forum sent in this information about Hormone Pellets. Some of you may find this very helpful information. There are links at the bottom of this post that will take you to more websites with additional data.

1 Hello, I’m Dr. Rebecca Glaser. This presentation on ‘Pellets’ will discuss a ‘method of delivery’ of hormones that is not well known, or rather, not well ‘remembered’ in the United States. Hopefully, by the end of the presentation you will realize that hormone replacement with pellets is the “Ultimate Hormone Therapy”.

2 Hormone pellets are the best, most natural way to deliver hormones in both men and women. Implants, placed under the skin, consistently release small, physiologic doses of bio-identical hormones providing optimal therapy.

3 What are Pellets? Pellets are made up of either estradiol or testosterone. The hormones, estradiol or testosterone, are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac’. In the United States, pellets are made by a compounding pharmacist and delivered in sterile glass vials.

4 Why pellets? Pellets deliver consistent, healthy levels of hormones for 4-6 months. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. It is the fluctuation in hormones that causes many of the unwanted side effects and symptoms a patient experiences. Estrogen delivered by subcutaneous pellets, maintains the normal ratio of estradiol to estrone. This is important for optimal health and disease prevention. Pellets do not increase the risk of blood clots like conventional or synthetic hormone replacement therapy.

5 In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, improvement in sex drive, libido, sexual response and performance. Even patients who have failed other types of hormone therapy have a very high success rate with pellets. In addition, there is no other method of hormone delivery that is as convenient for the patient as pellets.

6 Pellets have been used in both men and women since the late 1930’s. In fact, there is more data to support the use of pellets than any other method of delivery of hormones.

7 How and where do you insert pellets? The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the lower abdominal wall or hip through a small incision which is taped closed. Experience of the health care professional counts, not only in placing the pellets, but in determining the correct dosage of hormones to be used.

8 Complications from the insertion of pellets include minor bleeding, bruising, discoloration of the skin, infection, and possible extrusion of the pellet. Other than slight bruising, or discoloration of the skin these complications are very rare. Vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men. Antibiotics may be given if a patient is diabetic or has had a joint replaced.

9 You may wonder why you haven’t heard of pellets. Pellets are not patented and not marketed in the United States. They are frequently used in Europe and Australia where pharmaceutical companies produce pellets. Most of the research on pellets is out of England and Australia with some from Germany and the Netherlands. Pellets were frequently used in the United States from about 1940 through the late 70’s, early 80’s when patented estrogens were marketed to the public. In fact, some of the most exciting data on hormone implants in breast cancer patients is out of the United States. Even in United Stated there are clinics that specialize in the use of pellets for hormone therapy.

10 If your health care practitioner says that there is no data to support the use of pellets, he or she is wrong. There is a big difference between ‘no data’ and not having read the data.

11 Likewise, many patients have been told by their physicians, that there is ‘no data to support bio-identical hormone therapy’. It is much easier for busy practitioners to say this and dismiss the patient, than it is to question their beliefs and do the research.

12 Remember, it’s your body, it’s your choice. It is about how you want to feel.

13 After pellets are inserted, patients may notice that they have more energy, sleep better and feel happier. Muscle mass and bone density will increase while fatty tissue decreases. Patients may notice increased strength, co-ordination and physical performance. They may see an improvement in skin tone and hair texture. Concentration and memory may improve as will overall physical and sexual health.

14 Pellets do not have the same risk of breast cancer as high doses of oral estrogens, like Premarin, that do not maintain the correct estrogen ratio or hormone metabolites. Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women’s Health Initiative Trial. In fact, data supports that balanced hormones are breast protective.

15 When a patient first starts hormone therapy there may be mild, temporary breast tenderness which gets better on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain which will also resolve on its own. The body will tone up, as bone density and muscle mass increase and fatty tissue decreases.

16 Some patients begin to ‘feel better’ within 24-48 hours while others may take a week or two to notice a difference.

17 The pellets usually last between 4 and 5 months in women and 5-6 months in men.

18 The pellets do not need to be removed. They completely dissolve on their own.

19 Pellets are an excellent way to deliver testosterone in men, providing consistent levels of testosterone while maintaining normal estrogen levels.

20 Any time estradiol is prescribed, progesterone is also prescribed. There are progesterone (not progestin) receptors in the bone, brain, heart, breast and uterus. Progesterone can be used as a topical cream, a vaginal cream, oral capsule, or sublingual drops or capsules. If a patient is pre-menopausal she uses the progesterone the last two weeks of the menstrual cycle.

21 Hormone therapy with pellets is not just used for menopause. Women at any age may experience hormone imbalance. Levels decline or fluctuate contributing to debilitating symptoms. Pellets are useful in severe PMS, post partum depression, menstrual or migraine headaches, and sleeping disorders. Pellets may also be used to treat hormone deficiencies caused by the birth control pill.

22 Hormone levels will be drawn and evaluated before therapy is started. This will include a FSH, estradiol, testosterone and free testosterone for women. Men need a PSA, estradiol, free estradiol, testosterone and possibly estrone prior to starting therapy. Levels will be reevaluated during hormone therapy at 4-6 weeks and again in 4-5 months. After the first years of therapy hormones levels are followed less frequently. The PSA in men is followed every 6-12 months.

23 Testosterone levels begin to decline in men beginning in their 30’s. Most men maintain adequate levels of testosterone into their mid 40’s to mid 50’s, some into their late 70’s early 80’s. Men should be tested when they begin to show signs of testosterone deficiency. Even men in their 30’s can be testosterone deficient and show signs of bone loss. Most men need to be tested around 50 years of age. It is never too late to benefit from hormone therapy.

24 The cost for the insertion of pellets is between $230 and $600 depending on the dose of the hormone and the number of pellets needed. Men need a much larger dose of testosterone than women and the cost is higher. Pellets need to be inserted 2 to 3 times a year depending on how rapidly a patient metabolizes hormones.

25 When compared to the cost of drugs to treat the individual symptoms of hormone decline, pellets are very cost effective. There is more data on pellets and bone density than any chemical drug on the market. This slide only addresses the cost of medications used for bone density. It is beyond the scope of this presentation to examine the cost of drugs used for insomnia, depression, sexual dysfunction, obesity, diabetes, hypertension and more.

Related websites:

http://www.drwilsonobgyn.com/health_topics/menopause_hormones.html

http://www.biobalance4women.com/

http://www.hormonebalance.org/

http://www.hormonebalance.org/pellets_info.asp

http://www.hormonebalance.org/files/Insurance%20Letter%20Pellets.doc

http://www.sottopelletherapy.com/

http://www.bodylogicmd.com/Bioidentical_Hormone_Pellet_Therapy.html

http://www.longevityhouston.com/about-physicians.html